Papiso ea litekanyo tse phahameng le tse tlase tsa khatello ea mali

Papiso ea litekanyo tsa khatello ea mali likarolong tse ka holimo le tse tlaase le litekanyo tsa khatello ea mali ho bana ba tlas'a anesthesia e tloaelehileng
Seth Hayes, 1 Rebecca Miller, 1 Ambrish Patel, 2, 3 Dmitry Tumin, 1, 2 Hina Valiya, 1 Mohammed Hakim, 1 Fayzaan Syed, 1 Joseph D. Tobias 1, 2, 41 Lefapha la Anesthesiology and Pain Medicine, National Children's Sepetlele sa Columbus, Ohio 43205, USA;2 Lefapha la Pediatrics, Ohio State University, Columbus, Ohio, 43210, USA;3 Setsi sa Tlhokomelo e Hlōla ea Bana, Sepetlele sa Sechaba sa Bana, Columbus, Ohio, 43205, USA;4 Lefapha la Anesthesiology and Pain Management, Ohio State University, Columbus, OH 43210, USA Mongoli ea lumellanang: Seth Hayes Lefapha la Anesthesiology le Tlhokomelo ea Bohloko, Sepetlele sa Sechaba sa Bana, 700 Children's Drive, Columbus, OH 43205, USAtel +1 614 702 Fax 420 + 1 614 722 4203 khatello ea mali e hlaselang (IBP) ho baloa ha li-tube khahlanong le litekanyo tsa khatello ea mali e sa hlaseleng (NIBP) ka li-cuffs tsa oscillometric tsa lipheletsong tse ka holimo le tse tlaase ho masea le bana ba tlas'a anesthesia e tloaelehileng.MAMOLA LE MEKHOA.Boithuto ba rona bo kenyelelitse bakuli ba ka tlase ho lilemo tse 10 haeba ba ne ba fumana anesthesia e akaretsang mme ba rera catheterization ea methapo ea radial.IBP e ne e lekanngoa metsotso e meng le e meng ea 5 ka transducer ea hydrodynamic, 'me NIBP e ne e lekantsoe ka li-oscilloscope tse peli tse nang le li-cuffs tse lekaneng tse behiloeng letsohong le ka holimo le leoto le ka tlaase,' me litekanyo tsa 10 li ne li nkoa ho mokuli e mong le e mong.Liphello: Thuto e kenyelelitse bashanyana ba 18 le banana ba 12 ba lilemo tse 0 ho isa ho tse 8.Lintlheng tsa lintlha tsa 300, phapang e feletseng pakeng tsa letsoho le bolelang khatello ea mali (MAP) le litekanyo tse hlaselang e ne e le 7 ± 7 mmHg.Art.(range: 0–52 mmHg).Phapang e feletseng pakeng tsa tekanyo ea SBP leoto le mokhoa oa ho hlasela e ne e le 8 ± 8 mm Hg.Art.(range: 0–52 mmHg). Le hoja libaka tse peli tsa litekanyo tse sa hlaselehang li ne li bontša ho kheloha khafetsa ho tloha litekanyong tse hlaselang, ho kheloha ho hoholo ho ne ho tloaelehile ha BP e ne e lekanngoa leotong (81 ea 298 observations (27%) e kheloha> 10 mmHg) ha e bapisoa le letsoho (60 ea 300 litemoso. (20%) e kheloha ka> 10 mmHg) Qetello: Khafetsa ea ho kheloha ha NIBP ea bohlokoa ho bana ba tlas'a anesthesia e tloaelehileng e tšehetsa bohlokoa ba ho hlahloba IBP ha ho fetoha ha hemodynamic ho ka etsahala 'me ho ka ba kotsi ka ho khetheha. Le hoja libaka tse peli tsa litekanyo tse sa hlaselehang li ne li bontša ho kheloha khafetsa ho tloha litekanyong tse hlaselang, ho kheloha ho hoholo ho ne ho tloaelehile ha BP e ne e lekanngoa leotong (81 ea 298 observations (27%) e kheloha> 10 mmHg) ha e bapisoa le letsoho (60 ea 300 litemoso. (20%) e kheloha ka> 10 mmHg) Qetello: Khafetsa ea ho kheloha ha NIBP ea bohlokoa ho bana ba tlas'a anesthesia e tloaelehileng e tšehetsa bohlokoa ba ho hlahloba IBP ha ho fetoha ha hemodynamic ho ka etsahala 'me ho ka ba kotsi ka ho khetheha.Le hoja libaka tse peli tsa litekanyo tse sa hlaselehang li ne li bontša ho kheloha khafetsa ho tloha tekanyong e hlaselang, ho kheloha ho hoholo ho ne ho tloaelehile ka litekanyo tsa BP tsa leoto (81 ea 298 observations (27%), e kheloha ho feta 10 mmHg) ha e bapisoa le letsoho (60 ea 300 tse hlokometsoeng) .(20%), e kheloha ka ho feta 10 mm Hg.Art.).Qetello.Khafetsa ea ho se tloaelehe ha NIBP ea bohlokoa ho bana ba tlas'a anesthesia e akaretsang e tiisa bohlokoa ba ho beha leihlo NIBP ha ho na le ho fetoha ha hemodynamic mme ho ka ba kotsi haholo.尽管两个非侵入性测量部位都显示出与侵入性测量的频繁偏差，但与手观部位都显示出与侵入性测量的频繁偏差，但与手观部位都显示出，在腿部测量的BP(298 次观察中的81 次（27 %）偏差> 10 mmHg）更常见(20%) 偏差> 10 mmHg).尽管 两 个 非侵入性 测量 部位 都 出次） 相比 在 测量 的 bp （298 次 中 的 81 次(27 （27 (27 %）偏差> 10 mmHg）更常见(20%) 偏差> 10 mmHg). Хотя оба неинвазивных места измерения показали частые отклонения от инвазивных измерений, АД, измеренное на ноге (81 из 298 298 298 из 300 наблюдений) %), отклонение> 10 мм рт.ст.) чаще (20 % отклонение). Le hoja libaka tse peli tsa litekanyo tse sa hlaselehang li ne li bontša ho kheloha khafetsa ho tloha litekanyong tse hlaselang, BP e lekantsoe leotong (81 ho ea ho tse 298 tse hlokometsoeng (27) ha li bapisoa le letsoho (60 ho ea ho tse 300 tse hlokometsoeng) %), ho kheloha> 10 mmHg) hangata ( 20% kheloha). > 10 мм рт.ст.). > 10 mmHg).MATS'ELISO.Khafetsa ea mefokolo ea bohlokoa ea bongaka ea NIBP ho bana ba tlas'a anesthesia e akaretsang e tiisa bohlokoa ba ho beha leihlo NIBP ha ho feto-fetoha ha hemodynamic ho ka etsahala ebile ho le kotsi haholo.Ha ho bapisoa le litekanyetso tsa NIBP tse fumanoang karolong e ka holimo ea letsoho, NIBP e lekantsoeng leotong le ka tlaase e ka 'na ea fella ka ho kheloha ho hoholo ho tloha khatellong ea methapo e lekantsoeng ka mokhoa o hlaselang.Mantsoe a bohlokoa: khatello ea mali e hlaselang, khatello ea mali e sa hlaseleng, khatello ea mali.
Tlhokomelo ea khatello ea mali (BP) e bile ea bohlokoa tšireletsong ea anesthesia e tloaelehileng ho tloha ha sphygmomanometer e amoheloa ke Dr. Harvey Cushing mathoasong a lilemo tsa bo-1900.Ho tloha ka 1986, ona esale e le tekanyetso e hlokoang ke Mokhatlo oa Amerika oa Lingaka tsa Anesthesiologists (ASA) nakong efe kapa efe ea anesthesia e akaretsang.Hobane litekanyo tsa khatello ea mali li tsamaisa liqeto tsa bohlokoa mabapi le taolo ea perioperative, ho se nepahale ho ka thatafatsa tlhahlobo e nakong le kalafo ea ho se tsitse ha hemodynamic.Hangata lingaka tsa bana li etsa qeto ea ho fana ka maro, lihlahisoa tsa mali le li-inotrope tse thehiloeng ho kheloha ho tloha ho "tloaelehileng" ea BP.1 Hobane khatello ea mali ea mali le hypotension ea intraoperative li bontšitsoe hore li amahanngoa le mathata a morao-rao, ho kopanyelletsa le ho hloleha ho matla ha renal, encephalopathy, myocardial infarction, stroke, le ho eketseha ha lefu la matsatsi a 30, litekanyo tse sa nepahaleng tsa BP li ka lebisa likotsing tse kotsi, tse sa tsejoeng tsa BP.2-5
Nakong ea opereishene, khatello ea mali e ka lekanyetsoa ka mokhoa o sa tsitsang ka cuff ea khatello ea mali ea oscillometric (NIBP) kapa ka mokhoa o hlaselang ka indwelling arterial cannula (IBP).Kofu ea oscillometric e koala mothapo oa mothapo oa mokuli ka ho o pupetsa hore o be tlas'a khatello e ka holimo ho khatello ea mali ea systolic (SBP) ebe e lekanya ho fetoha ha khatello ha cuff e ntse e theoha butle-butle.Ntho eo khatello e feto-fetohang ka ho fetisisa ke ho bolela khatello ea mali (MAP).SBP le khatello ea mali ea diastolic (DBP) joale li baloa ho ipapisitsoe le khatello ea mali e bolelang le mehlala ea oscillometric.Li-algorithms tsa lipalo tsena ke tsa thepa 'me li itšetlehile ka moetsi oa cuff oa NIBP.6 Ka lehlakoreng le leng, ts'oaetso ea methapo e hlaselang e lekanya SBP le DBP ka ho toba ho tloha maqhubu a khatello ea maikutlo.MAP e tsoa ho boleng bona.7
Liphuputso tse 'maloa li batlisisitse kamano ea VBP le NIBP ho bana ba nang le liphello tse tsoakaneng. Ka 2010, Meyer et al o ile a etsa phuputso e bontšang leeme le tlaase (<1 mmHg) tlhahlobo ea Bland-Altman ea khatello ea kelello e sa lekanyetsoang e bolelang ho masea a sa tsoa tsoaloa 'me a fana ka maikutlo a hore kamano pakeng tsa IBP le NIBP e ntlafetse ha theknoloji ea NIBP e ntse e tsoela pele. .8 Leha ho le joalo, O'Shea et al o hlokometse tšekamelo ea ho lebisa litekanyetso tse phahameng tsa NIBP ka bohata ho baahi bana ba bakuli ho sa tsotellehe tsoelo-pele ea lisebelisoa tse ncha, tse rarahaneng tsa NIBP, esita le ha ho ka khoneha hore ho be le lintho tse ferekanyang tse kang boholo ba cuff le boemo ba mosebetsi.9 Liphuputso tse eketsehileng ba hlahlobile litekanyo tsa BP ho bakuli ba kulang haholo ba bana. Ka 2010, Meyer et al o ile a etsa phuputso e bontšang leeme le tlaase (<1 mmHg) tlhahlobisong ea Bland-Altman ea khatello ea mali e sa lekanyetsoang ho masea a sa tsoa tsoaloa mme a fana ka maikutlo a hore kamano pakeng tsa IBP le NIBP e ntlafetse ha theknoloji ea NIBP e ntse e eketseha. e tsoetse pele .8 Leha ho le joalo, O'Shea et al o hlokometse tšekamelo ea ho ba le litekanyetso tse phahameng tsa NIBP ho baahi bana ba mokuli ho sa tsotellehe tsoelo-pele ea lisebelisoa tse ncha tsa NIBP, esita le ha lintlha tse ferekanyang tse kang boholo ba cuff le boemo ba ts'ebetso li felisitsoe. .9 Liphuputso tse ling li hlahlobile litekanyo tsa BP ho bakuli ba bana ba kulang haholo. В 2010 г.Meyer провели исследование, показывающее низкую погрешность (<1 мм рт. ст.) в анализе Бланда-Альтмана неинвающее низкую погрешность (<1 мм рт. ст.) доношенных детей и предположили, что корреляция между ИАД и НИАД улучшилась по мере того, как технология НИАД .8 Тем не менее, O'Shea et al. Ka 2010, Meyer et al o ile a etsa phuputso e bontšang phoso e tlaase (<1 mmHg) tlhahlobisong ea Bland-Altman ea khatello ea mali e sa lekanyetsoang e bolelang ho masea a sa tsoa tsoaloa 'me a fana ka maikutlo a hore kamano pakeng tsa IBP le NIBP e ntlafetse joaloka theknoloji ea NIBP .8 Leha ho le joalo. , O'Shea et al.o hlokometse mokhoa o lebisang ho boleng bo phahameng ba NIBP ho palo ena ea bakuli leha ho na le nts'etsopele ea lisebelisoa tse ncha, tse tsoetseng pele tsa NIBP, leha lintlha tse ferekanyang tse kang boholo ba cuff le boemo ba ts'ebetso li felisitsoe..9 Liphuputso tse ling li hlahlobile litekanyo tsa BP ho bana ba kulang haholo. 2010 年，Meyer 等人进行了一项研究，显示Bland-Altman 分析对早产儿无创测量的平均动聉压进了明随着NIBP 技术的进步，IBP 和NIBP 之间的相关性有所改善.8 然而，O'Shea 等人指出，尽管开发了更新、更复杂的NIBP 设备，但即使洹备，但即使洹备，但即使洹备，等可能的混杂因素，该患者群体的NIBP 值仍有错误升高的趋势. 2010 年 , meyer 等 进行 了一 研究 , 显示 显示 bland-altman 分析 早产儿 无 创 测量 的 动 脉g) ， 表明 随着 nibp 技术 的 ， , b 和 nibp 之间 nibp 之间nibp 之间 nibp 之间 nibp 之间 nibp 之间的 相关性 有所改善 .8 出然而 ， o'She ,了 更新 、 更 复杂 nibp 设备 ， 即使 消除 了 袖带 尺寸活动 等 可能的 混杂高的趋势。 В 2010 г.Мейер le др.провели исследование, показывающее, что анализ Бланда-Альтмана дает низкую погрешность (<1 мм рт. ст.) оношенных детей, и показал, что с развитием технологии НИАД существует значительная разница между ИАД. Ka 2010, Meyer et al.e entse phuputso e bontšang hore tlhahlobo ea Bland-Altman e fana ka phoso e tlaase (<1 mmHg) bakeng sa tekanyo e sa lekanngoeng e bolelang khatello ea mali ho masea a pele ho nako 'me e bontšitse hore ka tsoelo-pele ea theknoloji ea NIBP, ho na le phapang e khōlō pakeng tsa IAD.le NIBP, likamano li ntlafetse.of the population Tloaelo ea ho eketseha ha palo ea liphoso e ntse e tsoela pele.9 Phuputso e ’ngoe e ile ea hlahloba khatello ea mali ho bana ba kulang haholo.Ba babeli ba bona ba fumane "phapang e kholo" lipakeng tsa mekhoa ea ho shebella e hlaselang le e sa hlaseleng 'me ba etsa qeto ea hore ho nyenyefatsa khatello ea mali le hypotension ho bakuli ba PICU ho ka lebisa tlhokomelong e tlase.10,11 Ka lehlakoreng le leng, Ray et al.ba ithutile boleng ba khatello ea mali litsing tse peli tsa tlhokomelo e matla ea bana, 'me, ho ipapisitse le mokhoa o lebisang ho boleng bo tlase ba NIBP le diastolic, ba fihletse qeto ea hore khatello e feteletseng ea hypotension e ka ba ho fihla ho 40% ea nako eo.12
Hoa tsebahala hore cuff e boholo bo lekaneng e tlameha ho sebelisoa ho fumana 'malo o nepahetseng ka ho fetesisa o sa hlaseleng.American Heart Association (AHA) e khothalletsa hore bophara le bolelele ba senya se koetsoeng e be 40% le 80% ea sekalikoe se bohareng ba letsoho, ka ho latellana.13 Hoa tsebahala hore NIBP e ameha ke ho sisinyeha le mosebetsi oa taba, kaha tšusumetso e ka ntle e ka ama ho nepahala ha litekanyo tsa BP.13,14 Le hoja mehloli ena e ka 'nang ea e-ba ea phoso litekanyong tsa NIBP e hlokomeloa hantle, tekanyo ea leeme litekanyong tsa NIBP ho bana ha e e-s'o hlahe hantle.Haeba tlhahlobo e sa hlaseleng e atisa ho nyenyefatsa kapa ho nyenyefatsa khatello ea mali, e ka fana ka litekanyetso tse khothatsang ka bohata ho bakuli ba sa tsitsang ba hemodynamically.Ha u ithuta litekanyetso tsa NIBP ho bana ba tlas'a anesthesia e akaretsang, metsamao le liketso tsa lithuto ha li kenyeletsoe, tse ka lebisang litekanyong tse nepahetseng haholoanyane.Ka hona, re entse boithuto bona bo lebelletsoeng ho bapisa arterial cannulation IBP le NIBP e lekantsoeng ka li-cuffs tsa oscillometric tse kaholimo le tse tlase ho bana ba tlas'a anesthesia e akaretsang.Khopolo ea rona ea mantlha ke hore ho bala ha NIBP ho fetelletse BP ha ho bapisoa le lisebelisoa tse hlaselang.Ho na le boitsebiso bo fokolang ba ho bapisa lintlha tse ka holimo le tse tlaase tsa NIBP, kahoo qeto ea ho sebelisa leoto le itseng hangata ke ntho e sebetsang e thehiloeng boiketlong ba ho fihlella le tlhokahalo ea ho qoba li-catheter tsa peripheral IV.Ka hona, sepheo sa rona sa bobeli e ne e le ho batlisisa kamano le khethollo pakeng tsa litekanyo tsa NIBP tsa lehetla le leoto le tlaase.
Boithuto bona bo amohetsoe ke Boto ea Tlhahlobo ea Setheo (IRB) ea Sepetlele sa Bana sa Naha (Columbus, Ohio, USA) mme e entsoe ho latela Phatlalatso ea Helsinki.Phuputso e ngolisitsoe ho Clinicaltrials.gov (NCT03220906).Ho latela boteng ba mofuputsi, bakuli ba 30 ba ile ba thaothoa hore ba phethe thuto.Tumello ea tsebo ea molomo e ile ea fumanoa ho batsoali ba mokuli pele ba kenya letsoho thutong (ho tlosoa ha tumello e ngotsoeng ho fumanoe ho IRB).Bakuli ba ka tlase ho lilemo tse 10, sehlopha sa American Society of Anesthesiologists (ASA) sehlopha sa 1-3, se kenyelelitsoe thutong ea rona haeba ba ne ba ka fumana anesthesia e akaretsang e nang le elective radial artery cannulation.IBP e ne e lekantsoe ho sebelisoa hydrodynamic pressure transducer (Edwards Lifescience TruWave) e nang le pontšo e tsoelang pele ea BP (Philips Intellivue).NIBP e ne e lekantsoe ho sebelisoa li-oscilloscope tse peli tse arohaneng tsa mofuta o le mong (Philips Intellivue) tse nang le li-cuffs tsa boholo bo loketseng (ho ea ka litataiso tsa AHA) tse sebelisoang ho letsoho le ka holimo le leoto le ka tlaase.
Systolic, diastolic le ho bolela khatello ea mali (MAP) ho lintlha tsa 3 (radial artery, cuff arm le cuff ea leoto) li tlalehiloe ka nako ea metsotso ea 5 le litekanyo tsa 10 ka mokuli.Bakeng sa bakuli ba neng ba e-na le intraoperative cardiopulmonary bypass (CPB), lipontšo tsa 5 li ile tsa fumanoa pele ho qala CPB le lipontšo tsa 5 li ile tsa fumanoa ka mor'a ho phethoa ha tsela eo.Ho ile ha etsoa tlhahlobo ea pele ea matla bakeng sa teko ea karolo e le 'ngoe.Re hakanya hore thuto e tla hloka matla a 80% maemong a 185 ho bonts'a sekhahla sa phoso se fetang 10% bakeng sa litekanyo tse sa hlaseleng, tse nang le phoso e kholo ea 5% le boemo ba lipalo-palo ba 95%.Ho ngolisoa ho ile ha fokotseha ka mor'a hore bakuli ba 30 ba ngolisoe bakeng sa kakaretso ea 300 BP.
Sephetho se ka sehloohong e ne e le khethollo ea bohlokoa ea bongaka joalokaha e hlalosoa ke ho kheloha ha BP ea> 5 mmHg pakeng tsa IBP le NIBP. Sephetho se ka sehloohong e ne e le khethollo ea bohlokoa ea bongaka joalokaha e hlalosoa ke ho kheloha ha BP ea> 5 mmHg pakeng tsa IBP le NIBP. Первичным исходом была клинически значимая систематическая ошибка, определяемая отклонением АД> 5 мм рт. Sephetho sa mantlha e ne e le leeme la bohlokoa la bongaka, le hlalosoang e le ho kheloha ha BP> 5 mmHg.Art.pakeng tsa IBP le NIBP.主要结果是临床上显着的偏差，定义为IBP 和NIBP 之间的BP 偏差> 5 mmHg.主要结果是临床上显着的偏差， 定义为Первичной конечной точкой было клинически значимое отклонение, определяемое как отклонение АД> 5 мм рт. Qetello ea mantlha e ne e le ho kheloha ho hoholo ha kliniki, ho hlalosoang e le ho kheloha ha BP> 5 mmHg.Art.pakeng tsa IBP le NIBP.Hape re ile ra etsa lipatlisiso ka ketsahalo ea ho kheloha ho feta 10 mmHg.Lintlha tse tsoelang pele lipakeng tsa libaka li ile tsa bapisoa ho sebelisoa tlhahlobo ea Bland-Altman.15 Ka tlhahlobo ea mefuta e mengata, re sebelisitse liphello tse tsoakaneng ho etsa mohlala oa phapang e feletseng pakeng tsa NIBP le IBP e le mosebetsi oa NIBP, lilemo, tekano, boima ba 'mele, le boemo ba mokuli (bo tloaelehileng kapa bo ka holimo) ka mokhoa o ts'oanang le ho pheta-pheta ho sa tloaelehang boemong ba mokuli. Mokhoa o sa tloaelehang oa ho thibela mokuli o ne o sebelisetsoa ho ikarabella bakeng sa lintlha tsa mokuli tse neng li sa kenyelletsoa ka ho hlaka ho latela mohlala, empa tse neng li ntse li fapane pakeng tsa bakuli. 'me p<0.05 e ne e nkoa e le ea bohlokoa ka lipalo. Mokhoa o sa tloaelehang oa ho thibela mokuli o ne o sebelisetsoa ho ikarabella bakeng sa lintlha tsa mokuli tse neng li sa kenyelletsoa ka ho hlaka ho latela mohlala, empa tse neng li ntse li fapane pakeng tsa bakuli. 'me p<0.05 e ne e nkoa e le ea bohlokoa ka lipalo. Случайный перехват на уровне пациента использовался для учета факторов пациента, которые не были явно включены в ключены земя пациентами.16 Анализ данных был выполнен с использованием Stata/IC 14.2 (College Station, TX: StataCorp, LP), le p. <0,05 считалось статистически значимым. Mokhoa oa ho thibela mokuli ka tšohanyetso o ne o sebelisetsoa ho ikarabella bakeng sa lintlha tsa mokuli tse neng li sa kenyelletsoa ka ho hlaka mohlala empa li ntse li fapane pakeng tsa bakuli. 0.05 e ne e nkoa e le ea bohlokoa ka lipalo.Li-intercepts tse sa sebetseng tsa boemo ba mokuli li ne li sebelisetsoa ho ikarabella bakeng sa lintlha tsa mokuli tse neng li sa kenyelletsoa ka ho hlaka mohlala empa li ntse li fapane le mokuli. 16 使用Stata/IC 14.2（College Station，TX：StataCorp，LP）进行数据分析， p<0.05 被认为具有统计学意义. 16 使用Stata/IC 14.2（College Station，TX：StataCorp，LP）进行数据分析， p<0.05 被认为具有统计学意义. 16 Анализ данных проводили с использованием Stata/IC 14.2 (College Station, TX: StataCorp, LP), p<0,05 считалось статистически значимым. 16 Tlhahlobo ea lintlha e ile ea etsoa ho sebelisoa Stata / IC 14.2 (College Station, TX: StataCorp, LP), p <0.05 e ne e nkoa e le ea bohlokoa ka lipalo.Bafuputsi / bangoli ba ke ke ba arolelana lintlha tsa botho tsa bankakarolo.
Boithuto bona bo ne bo kenyelletsa bakuli ba 30, bashanyana ba 18 le banana ba 12 ba lilemo tse 0 ho isa ho tse 8.Ho buuoa ho ne ho kenyelletsa 28 (93%) ea opereishene ea sefuba, 1 (3%) ea methapo ea kutlo, le 1 (3%) ea opereishene ea masapo.Tafole ea 1 le ea 2 e akaretsa palo ea batho ba ithutoang 'me e bolela boleng ba SBP, DBP le SBP sebakeng se seng le se seng.Litekanyo tse leshome tsa BP kapa metsotso e ka bang 50 li ile tsa hlahlojoa bakeng sa mokuli e mong le e mong, ka kakaretso ea litekanyo tsa 300 kapa metsotso ea 15,000 ea ho hlahloba.
Sebakeng sa Bland-Altman (setšoantšo sa 1), phoso le ho nepahala ha NIBP (SBP) e lekantsoeng ka letsoho, mabapi le IBP, e ne e le -2 le 10 mm Hg.Art.ka ho latellana (95% meeli ea ho lumellana: -21, + 17 mmHg).Leeme le ho nepahala ha khatello ea methapo ea methapo e amanang le leoto la IBP e ne e le -5 le 11 mmHg.Art.ka ho latellana (95% ea meeli ea tumellano: -26, + 16 mmHg). Ha ho bapisoa IBP le NIBP letsohong, phapang e feletseng ho MAP e ne e le 7 ± 7 mmHg (range: 0-52 mmHg) le 143 ea litlhaloso tsa 300 (48%) e kheloha> 5 mmHg le 60 ea litlhaloso tsa 300 (20%). e fapoha ka > 10 mmHg. Ha ho bapisoa IBP le NIBP letsohong, phapang e feletseng ho MAP e ne e le 7 ± 7 mmHg (range: 0-52 mmHg) le 143 ea litlhaloso tsa 300 (48%) e kheloha> 5 mmHg le 60 ea litlhaloso tsa 300 (20%). e fapoha ka > 10 mmHg.Ha ho bapisoa IBP le NIBP letsohong, phapang e feletseng ho SBP e ne e le 7±7 mm Hg.Art.(диапазон: 0–52 мм рт. ст.) при 143 наблюдениях из 300 (48 %) с отклонением > 5 мм рт. (range: 0-52 mmHg) ka litlhaloso tsa 143 ho tsoa ho 300 (48%) ka ho kheloha> 5 mmHg.Art.le litebello tse 60 ho tse 300 (20%).отклонение >10 мм рт.ст. ho kheloha ho feta 10 mmHg比较手臂上的IBP 和NIBP 时，MAP 的绝对差异為7±7 mmHg（范围:0-52 mmHg），300 次观察中的143 欂次（50 mmHg)察中的60 次(20%) 偏差> 10 mmHg.比较 手臂 上的 IBP 和 nibp 时 ， mapa 的 差异 为 為 為 7 mmhg （范围 : 0-52 mmhg） 300 次 家家 8 14 ） 300 次 （ 52 mmhg hg, 300 次 中 中 的 60次 60 次 60 次 60 次 60 次 60 次 60 次 60 次 60 次 60 次 60 次 60 次 60 次 60Ha ho bapisoa IBP le NIBP letsohong, phapang e feletseng ho SBP e ne e le 7±7 mm Hg.(диапазон: 0-52 мм рт.ст.), с отклонениями >5 мм рт.ст. (range: 0-52 mmHg), ka liphapang> 5 mmHg. в 143 из 300 наблюдений (48%) и 60 из 300 наблюдений (20%) Отклонение > 10 мм рт.ст. ho tse 143 ho tse 300 tse hlokometsoeng (48%) le tse 60 ho tse 300 (20%) Ho kheloha > 10 mm Hg. Ha ho bapisoa IBP le NIBP leotong, phapang e feletseng ho MAP e ne e le 8 ± 8 mmHg (range: 0-52 mmHg) le 169 ea litlhaloso tsa 298 (57%) e kheloha> 5 mmHg le 81 ea litlhaloso tsa 298 (27%). e fapoha ka > 10 mmHg. Ha ho bapisoa IBP le NIBP leotong, phapang e feletseng ho MAP e ne e le 8 ± 8 mmHg (range: 0-52 mmHg) le 169 ea litlhaloso tsa 298 (57%) e kheloha> 5 mmHg le 81 ea litlhaloso tsa 298 (27%). e fapoha ka > 10 mmHg.Ha ho bapisoa VBP le NIBP leotong, phapang e feletseng ho SBP e ne e le 8 ± 8 mm Hg.Art.(range: 0-52 mmHg), e nang le 169 ea litlhaloso tsa 298 (57%) e kheloha ho feta 5 mmHg.Art.и 81 из 298 наблюдений (27%) отклонение >10 мм рт.ст. le 81 ho tse 298 tse hlokometsoeng (27%) ho kheloha > 10 mmHg.将IBP 与腿部的NIBP 进行比较时，MAP 的绝对差异為8±8 mmHg（范围:0-52 mmHg），298次观察察中%169>298 次观実察中%169 ,772 98 次观察中的81 ho feta (27%) ho feta ho feta 10 mmHg.将 IBP 与 腿部 nibp 进行时 ， mapa 的 差异 为 為 8 ± 8 mmhg （范围 : 0-52 mmhg） ， 298 次 16 ） 298 次 16 ）差> 5 mmhg , 298 次 观察的的 中 中 中 中 中 中 中 中 中 中 中 中 中 中 中 中 中 HIP 81 次 (27%）偏差> 10mmHg).Ha ho bapisoa VBP le NIBP leotong, phapang e feletseng ho SBP e ne e le 8 ± 8 mm Hg.Art.(диапазон: 0–52 мм рт. ст.), при этом 169 из 298 наблюдений (57%) имели отклонение > 5 мм рт. (range: 0-52 mmHg), le 169 ea 298 tse hlokometsoeng (57%) e nang le ho kheloha> 5 mmHg.Art.и 1 из 298 наблюдений 81 (27%) отклонения > 10 мм рт.ст. le 1 ea maikutlo a 298 81 (27%) e kheloha> 10 mmHg.
Raese.1. Morero oa Bland-Altman oa ngollano pakeng tsa litekanyo tse hlaselang tsa khatello ea mali (MAP) le litekanyo tse sa hlaseleng tsa SBP.
Letlapa la 3 le bontša liphello tsa ho bapisa SBP le DBP pakeng tsa libaka.Le hoja libaka tse peli tsa NIBP li bontšitse ho kheloha ho tloha ho NIBP, ho kheloha ho hoholo ho ne ho tloaelehile ha NIBP e fumanoa maotong.Letlapa la 4 le bonts'a mohlala oa multivariate o bolelang esale pele palo ea ho kheloha ha SBP ho tloha ho litekanyetso tsa IBP ho sebelisa litekanyo tsa NIBP matsohong le maotong.Bong, lilemo, boima ba 'mele, le sebaka sa mokuli li ne li sa amahanngoa le leeme litekanyong tse hlaselang tsa MAP.Ha ho bapisoa le litekanyo tsa NIBP tsa letsoho, ho kheloha ka ho feletseng ha SBP ho tloha litekanyong tsa IBP e ne e le 1.5 mmHg.Art.ho feta maotong (95% CI: 0.4, 2.6; p = 0,009).Papiso e tobileng ea letsoho la NIBP le leoto la NIBP (setšoantšo sa 2) se bontšitse phapang e feletseng ho SBP ea 2.5 ± 10 mmHg.Art.(95% meeli ea tumellano: -17.1, +22.0 mmHg).
Letlapa la 3 Papiso ea khatello ea mali e bolelang, systolic, le diastolic matsohong le maotong le arterial cannulation.
Letlapa la 4 Phapang pakeng tsa khatello e boletsoeng esale pele ea khatello ea mali le tekanyo e hlaselang ka ho sebelisa mekhoa e tsoakaneng ea mokhoa oa ho khutlela morao.
Raese.2. Morero oa Bland-Altman oa ngollano pakeng tsa litekanyo tse sa tsitsang tsa khatello ea mali e bolelang (MAP) matsohong le maotong.
Lithuto tse fetileng tse bapisang litekanyo tsa NIBP le IBP ho bana ba hlasetsoeng ka lithethefatsi li na le moeli.Leha litaba tsa masea a sa tsoa tsoaloa li hanyetsana, liphuputso tse ling li bontša tšekamelo e lebisang khatellong e phahameng ea mali ha e lekantsoe ka mokhoa o sa hlaseleng.Joffe et al.e fumane hore ho palo e boima ea bana, phapang pakeng tsa litekanyo tsa NIBP le IBP ho bana ba 100 e ne e le nyenyane ka karolelano, empa ho kheloha ho tloaelehileng, lihlopha tsa interquartile, le merero ea Bland-Altman e ne e e-na le tumellano e mengata.Lithuto tsena ha lia ka tsa etsoa ho bakuli ba tlas'a anesthesia e tloaelehileng, e leng tšobotsi e ka 'nang ea e-ba molemo ea thuto ea rona e ka fokotsang liphoso tsa mokuli ho sisinyeha kapa mosebetsi.Leha ho le joalo, ho tšoana le liphello tsa Ioffe, liphetho tsa rona li bontša hore le hoja litekanyo tsa IBP le NIBP ho bana ba nang le bothata ba ho robala hangata li lumellana, litekanyo tsa NIBP ka bomong hangata ha li nepahale, tse bontšang bobeli ho feta tekano le ho nyenyefatsa BP.Liphapang tse kholo tsa tšebeliso ea NIBP hangata li hlahile nakong ea thuto.Liphapang tsena tsa IBP tse fumanoeng ho tloha litekanyong tsa NIBP tsa leoto le ka tlaase li ne li le kholoanyane ebile li atisa ho feta ho kheloha ho fumanoang litekanyong tsa NIBP ea lehetla.
Papiso ea litekanyo tsa NIBP matsohong le maotong ho bana e tlalehiloe pele.Ka 2000, Short et al.o ithutile NIBP ho bana ba 50 tlas'a anesthesia. Ho bana ba lilemo li 8 le tlase, BP e fumanoeng ho tloha leoto le ka tlaase e ne e le tlase haholo ho feta e lekantsoeng ho tloha ka holimo ho letsoho (p <0.05) .17 Ho fapana le sena, thuto ea rona e ile ea bapisa letsoho le leoto la NIBP ho litekanyo tsa IBP. Ho bana ba lilemo li 8 le tlase, BP e fumanoeng ho tloha leoto le ka tlaase e ne e le tlase haholo ho feta e lekantsoeng ho tloha ka holimo ho letsoho (p <0.05) .17 Ho fapana le sena, thuto ea rona e ile ea bapisa letsoho le leoto la NIBP ho litekanyo tsa IBP. 8 лет и младше АД, змеренное на голени, было значительно ниже, чем измеренное на плече (p<0,05).17 ИАД руки и ноги сравнивали с измерениями НИАД. Ho bana ba lilemo li 8 le ho feta, khatello ea mali e lekantsoeng leotong le ka tlaase e ne e le tlase haholo ho feta e lekantsoeng ka letsoho le ka holimo (p <0.05) .17 Ka lehlakoreng le leng, thutong ea rona, letsoho le leoto la NIBP le ne le bapisoa le litekanyo tsa NIBP.在8 岁及以下儿童中，从小腿测得的血压显着低从上臂测得的血压(p<0.05). 8 8 лет и младше артериальное давление, измеренное на голени, было значительно ниже, чем на плече (p<0,05). Ho bana ba lilemo li 8 le ho feta, khatello ea mali e lekantsoeng ka leoto le ka tlaase e ne e le tlase haholo ho feta letsoho le ka holimo (p <0.05).17 Ka lehlakoreng le leng, thuto ea rona e ile ea bapisa NIBP ea matsoho le maoto le litekanyo tsa IBP.Liphello tsa rona li bontšitse hore BP le BP li ne li tloaelehile haholo maotong, e leng se ka 'nang sa bontša hore namane NIBP ha e tšepahale ho feta NIBP e ka holimo ea letsoho.
Thutong ea rona, tekanyo ea phetoho ea BP e ile ea hlahlojoa ho sebelisoa litekanyetso tsa 5 le 10 mm Hg.Art., tse nang le mohlala oa ho hlahloba ho nepahala ha lisebelisoa tse ikemetseng bakeng sa ho lekanya khatello ea mali.18 Le hoja phapang ho SBP ea 5 kapa 10 mmHg Art.e lekane bakeng sa batho ba baholo ba nang le BP ea perfusion, lintho tsena tse sa tloaelehang li ka 'na tsa bonahala haholo ho bana, haholo-holo ba nang le moeli o phahameng kapa o tlaase oa BP, kaha BP ea bona e tloaelehileng e tlaase.Ho tsosa khatello ea mali ho bana ba lilemo li 2 (lilemo tse bolelang tsa palo ea batho ba ithutoang) e ne e le 90-105/55-70.Khatello e tloaelehileng ea mali ho masea a likhoeli tse 0-3 ke 65-85/45-55.Art.ho bakuli ba ho qetela ba ka lebisa ho hyperperfusion e matla kapa hypoperfusion, bothata bo ka lebisang ho senyeha le ho se sebetse ha litho tse lebisitsoeng.Ntle le moo, litekanyetso tsena tse tloaelehileng tsa khatello ea mali li tla fokotsoa le ho feta tlasa anesthesia e akaretsang.mashome a mabeli
Le hoja ho se na mekhoa e tsitsitseng ea MAP ho feta kapa ka tlas'a tekanyo libakeng tse peli tsa tekanyo ea NIBP, liphetho tsa rona li atolosa liphuputso tsa lithuto tse fetileng ha li bapisoa le litekanyo tsa BP tse hlaselang le tse sa tsitsang ho bana, tse hlokometseng hore phapang pakeng tsa NIBP le IBP e tloaelehile.Habohlokoa, thuto ea rona e felisitse liphoso tsa tekanyo ea NIBP tse bakoang ke ho sisinyeha ha mokuli kapa mosebetsi ha bakuli ba rona ba ne ba le tlas'a anesthesia ka kakaretso.Liphetho tsa rona li totobatsa tlhoko ea nts'etsopele e eketsehileng ea li-monitor tse nepahetseng, tse sa hlaseleng khatello ea mali le mesebetsi ea hemodynamic.Khafetsa ea liphetoho tse kholo tsa kliniki e boetse e tiisa bohlokoa ba ho hlahloba ka mokhoa o hlaselang ha ho se tsitse ha hemodynamic kapa khatello e tlaase ea mali kapa hypotension e lebeletsoe ho ameha ka ho khetheha ho bakuli.
Liphetho tsa thuto ea hajoale li ka fokotsoa ke mehloli e ka bang teng ea phoso.Re nka IBP tekanyetso ea rona ea khauta bakeng sa ho bapisa litekanyo tsa NIBP.Ha u lekanya khatello ea mali e hlaselang ka transducer e kopantsoeng le mokelikeli, ho se nepahale ho feteletseng kapa ka tlase ho tekanyo ho ka 'na ha etsahala ho itšetlehile ka boholo ba catheter ea intra-arterial, li-bubble tsa moea tsamaisong, kinked kapa compressed tubing, kapa displaced arterial cannula.9 Tekanyo ea Pele Kapa liphoso li ka etsahala ha u beha transducer boemong ba atrium e nepahetseng ea mokuli.Litekanyo tsa NIBP li ka angoa ke cuff ea boholo bo sa nepahalang ea BP kapa tšusumetso e kantle.Le ha ho khothaletsoa ho latela likhothaletso bakeng sa khetho ea li-cuff tsa AHA, khetho ea boholo ba cuff e qetella e le ka boikhethelo ba basebetsi ba ngakeng.Mokhoa ona o theha ts'ebetso ea khetho ea cuff e lumellanang le tloaelo ea rona ea kliniki.Maemo a bakoang ke khatello ke litšekamelo tse kholo tsa bongaka tse lebelletsoeng ho etsahala ka ntle ho sebaka sa phuputso ena.Ho phaella moo, ha ho na tlhahiso ea AHA bakeng sa ho fokotsa sekhahla sa namane ea khatello ea mali, kahoo bafani ba 'nile ba bua ka litlhahiso tsa boholo ba letsoho la AHA ha ba sebelisa li-cuffs tsa namane.Boemo ba ts'ebetso ea mokuli ha bo na monyetla oa ho fetoha tlas'a anesthesia e akaretsang, empa khatello ea kantle ea cuff ke ngaka e buoang, lisebelisoa, kapa basebetsi ba ka khonahala.
Boithuto ba rona bo ne bo bapisa litekanyo tsa khatello ea mali tse fumanoeng ka kotloloho ho tsoa litekanyong tsa cuff oscillation le tse fumanoang ho tsoa mefuteng e hlaselang ea maqhubu a khatello.Ka mokhoa o ts'oanang, SBP le DBP tse fumanoeng tsa cuff e oscillating li ne li bapisoa le boleng bo lekantsoeng ka kotloloho ba leqhubu la khatello ea pulse.Ha rea ​​ka ra ikarabella ka lintho tse ka ferekanyang tse kang tšebeliso ea li-vasopressors, 'me radial vasoconstriction e ka eketsa phoso pakeng tsa IBP le NIBP.Hape ke habohlokoa ho hlokomela hore khatello ea mali e ka fapana likarolong tse sa tšoaneng tsa 'mele.Ho kheloha ho fumanoang pakeng tsa NIBP maotong le BP matsohong (e hlaselang kapa e sa hlaseleng) e ka 'na ea bontša phapang ea sebele ea khatello ea mali libakeng tsena.Ho phaella moo, bakuli ba rona ba bangata ba etsoa opereishene ea sefuba, e ka bang le tšusumetso e kholo khatellong ea mali matsohong ho feta maotong.Le hoja re sa ka ra laola ka ho hlaka hore na litekanyo tsa NIBP le IBP li ne li etsoa libakeng tse tšoanang kapa tse fapaneng tsa bakuli, re sebelisitse ho fokotseha ha liphello tse tsoakaneng ho ikarabella bakeng sa lintlha tsa boemo ba mokuli tse sa kenyelletsoeng ka ho hlaka mohlaleng oa rona.Ka hona, liphello tse sa reroang li ile tsa nka liphapang tsena tsa boemo ba mokuli, tse neng li lula li le teng pakeng tsa litebello tsa mokuli a le mong.Le hoja mekhoa ea rona ea ho kenyelletsa thuto e ne e le bana ba ka tlaase ho lilemo tse 10, ha e le hantle boholo ba bakuli ba rona ba ne ba le ba banyenyane haholo.Ka hona, liphetho tsa rona li kanna tsa se ke tsa akaretsa bana ba baholoanyane.Liphetho tsa rona le tsona li ile tsa fokotsoa ke lisebelisoa tsa ho beha leihlo tse sebelisitsoeng.Ho na le phapang lipakeng tsa khatello ea mali lipakeng tsa bahlahisi ba fapaneng ba li-monitor.Baetsi ba li-cuff tsa Oscillometric ba sebelisa li-algorithms tse fapaneng mme liphetho tsa rona li sebetsa feela ho lisebelisoa tse sebelisoang thutong ea rona.13:21–24
Taba ea hore litekanyetso tse ling li fapana le ho baloa ha IBP ka ho feta 30-40 mmHg e supa monyetla oa mohloli o joalo oa phoso.Hobane boitsebiso bo tlalehiloe ke bafuputsi, ho ne ho ke ke ha khoneha ho fumana hore na ke eng e bakileng phetoho e kholo joalo le ho fumana hore na ho baloa ho nepahetse.Ho boloka bots'epehi ba thuto, litekanyetso tsena li ile tsa tlalehoa 'me tsa kenyelletsoa sehlopheng sa boithuto.Ho phaella moo, re tlalehile data ea BP ka nako ea metsotso ea 5, empa re belaela hore tlhahlobo ea lisebelisoa tsa tlhahlobo ea NIBP e tsoelang pele e bokelletsoeng ka elektroniki e ka senola ho se lumellane ho hoholo pakeng tsa litekanyo tsa IBP le NIBP.
Lintlha tsa rona li ncha kaha li tsoa ho bakuli ba tlas'a anesthesia e tloaelehileng, empa li lumellana le lithuto tse fetileng tse bapisang kamano ea litekanyo tsa khatello ea mali tse hlaselang le tse sa hlaseleng.Khafetsa ea lintho tse sa tloaelehang tsa NIBP tsa bongaka li tiisa bohlokoa ba ho beha leihlo NIBP ha ho ka etsahala hore ho feto-fetoha ha hemodynamic kapa ha ho fetoha hona ho le kotsi haholo.Ho phaella moo, leoto le tlaase la NIBP le ne le ka 'na la fella ka ho kheloha ho hoholo hoa kliniki ho tloha ho khatello e matla ea methapo ea mali ho feta NIBP e ka holimo ea letsoho.Ka lebaka la liphetho tsa rona, liqeto tse mabapi le ho beoa ha cuff ha lia lokela ho ba tse sa reroang, empa re khothaletsa ho sebelisa letsoho neng kapa neng ha ho khoneha nakong ea tlhahlobo ea khatello ea mali.
1. Mogane P. Na tekanyo ea khatello ea mali e bohlokoa baneng?Itloaetse S Afr Fam.2013;55(Sehlomathiso 1):S36–S39.
2. Walsh M., Devereux PJ, Garg AS et al.Kamano lipakeng tsa khatello ea methapo ea methapo le sephetho sa bongaka kamora ho buuoa ntle le pelo: tlhaloso e matla ea hypotension.Theko ea Bohloko.2013;119:507–515 .
3. Salmasi V, Maheshwari K, Jan D, et al.Kamano pakeng tsa hypotension ea intraoperative (e hlalosoang e le ho fokotseha ho tloha ho ea pele kapa moeling o feletseng) le kotsi e matla ea liphio le myocardial ka mor'a ho buuoa ka ntle ho pelo.Theko ea Bohloko.2017;126:47-65.
4. Biiker JB, Persun S, Pilen L, et al.Intraoperative hypotension le perioperative ischemic stroke ka mor'a ho buuoa ka kakaretso.Theko ea Bohloko.2012;116:658–664 .
5. McCann ME, Schouten ANJ, Dobija N, le ba bang.Postoperative encephalopathy ho masea: Lintlha tse amanang le perioperative tse lokelang ho ameha ka tsona.Lingaka tsa bana.2014;133:e751–757.
6. Alpert BS, Quinn D, Gallik D. Oscillometric khatello ea mali: tlhahlobo ea ngaka.J Am Soc Hypertension.2014;12:930–938.
[PubMed] 7. Barash PG, Cullen BF, Stolting RK, Kakhalan MK, Stock MS, Ortega R. Clinical anesthesia.Khatiso ea 7.Philadelphia, PA: LWW;2013: 706-709.
8. Meyer S, Sander J, Graber S, Gottschling S, Gortner L. Ho lumellana pakeng tsa khatello ea mali e hlaselang le e sa hlaseleng masea a pele ho nako ho sa tsotellehe boima ba tsoalo kapa lilemo tsa boimana.Journal of Pediatric Child Health.2010;46:249–254.
9. O'Shea J., Dempsey EM Ho bapisa litekanyo tsa khatello ea mali ho masea a sa tsoa tsoaloa.Ke J. Perinatol.2009;26:113-116 .
10. Holt TR, Withington DE, Mitchell E. Ke khatello efe ea ho lumela?Papiso ea tekanyo e tobileng ea khatello ea mali le tekanyo ea khatello ea mali e sa tobang setsing sa tlhokomelo e matla ea bana.Tlhokomelo ea Bana ea Crit Med.2011;12:e391–e394.
11. Joffe R., Duff J., Guerra GG, Pugh J., Joffe AR Ho nepahala ha li-catheter tsa arterial le li-cuffs tsa khatello ea mali tse sa hlaseleng bana ba kulang haholo.Tlhokomelo e Bohlokoa.2016;20:177.
12. Ray S., Rogers L., Noren DP et al.Kotsi ea ho hlahlojoa ho feteletseng ha hypotension ho bana: tlhahlobo ea papiso ea litekanyo tse fetang 50,000 tsa khatello ea mali.Meriana ea tlhokomelo e matla.2017;43(10):1540–1541.
13. Pickering TG, Hall JE, Appel LJ et al.Litlhahiso tsa Tekanyo ea Khatello ea Mali ho Batho le Liphoofolo tsa Laboratori: Polelo ea Setsebi e tsoang ho Komiti ea Thuto ea Setsebi le ea Sechaba ea Komiti ea Lipatlisiso ea Hypertension ea American Heart Association.potoloho.2005;111:697–716 .
14. Clark JA, Li-Lai MV, Sarnaik A., Mattu TK Phapang pakeng tsa tekanyo ea khatello ea mali e tobileng le e sa tobang ho sebelisa likhetho tse fapaneng tsa cuff.Lingaka tsa bana.2002;110:920-923 .
15. Manta S, Roizen MF, Fleisher LA, Thisted R, Foss J. Papiso ea litekanyetso tsa kliniki: litekanyetso tsa tlaleho bakeng sa Bland le Altman litlhahlobo.Anesthesia le boiketlo.2000;90:593–602.
[PubMed] 16. Froysteter AB, Tumin D, Whitaker EE, et al.Li-tissue li fetoha le oksijene ea boko ka mor'a hore ho hlajoe bohloko ba mokokotlo ho masea: thuto e lebelletsoeng.J Anes.2018;32:288–292 .
17. Mkhutshwane.Tekanyo e sa tsitsang ea khatello ea mali karolong e ka holimo le e ka tlaase ho bana ba tlas'a anesthesia.Anesthesia ea bana.2000;10:591–593 .
18. O'Brien E, Petrie J, Littler W, le ba bang.Protocol ea Mokhatlo oa Brithani oa Hypertension bakeng sa tlhahlobo ea lisebelisoa tsa khatello ea mali tse ikemetseng le tse ikemetseng tse amanang haholo le litsamaiso tse matla.G Khatello ea mali.1990;8:607–619 .
19. Cat S, Lerman J, Anderson B. Tloaelo ea anesthesia ho masea le bana.Khatiso ea 5.Philadelphia: Elsevier, 2013.
20. de Graaff JK, Pasma W, van Buuren S, et al.Litekanyetso tse sa hlaseleng tsa khatello ea mali ho bana nakong ea anesthesia: thuto ea sehlopha sa batho ba bangata ba retrospective.Theko ea Bohloko.2016;125(5):904–913.
21. Dannevig I, Dale HC, Liestøl K, Lindemann R. Khatello ea mali ea lesea la lesea: li-monitor tse tharo tse sa tsitsang tsa khatello ea oscillometric khahlanong le tekanyo ea khatello ea mali e hlaselang.Journal of Pediatrics.2005;94:191–196 .
22. Papadopoulos G, Mike S, Elisaf M. Tlhahlobo ea katleho ea li-tonometer tse tharo tsa oscillometric ho masea a sa tsoa tsoaloa a sebelisa simulator.Ho hlahloba khatello ea mali.1999;4:27-33.
23. Diproz GK, Evans D.Kh., Archer LN, Leven MI Dinamap ha e khone ho lemoha khatello e tlaase ea mali ho masea a tsoaloa a tlaase haholo.Arch Dis ngoana.1986;61:771–773 .
24. Litsamaiso tsa bongaka tsa Philips.510(k) Tsebiso ea pele bakeng sa software ea Intellivue Information Center.Silver Springs, MD: Lefapha la US la Bophelo bo Botle le Litšebeletso tsa Botho Tsamaiso ea Lijo le Lithethefatsi; 2019. E fumaneha ho tsoa: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfPMN/pmn.cfm?start_search=1&Center=&Panel=&ProductCode=DSI&KNumber=&Applicant=PHILIPS%20MEDICAL%20SYSTEMS&TypeRevice=TypeReview =&ClinicalTrials=&Decision=&DecisionDateFrom=&DecisionDateTo=07%2F24%2F2019&IVDProducts=&Redact510K=&CombinationProducts=&ZNumber=&PAGENUM=10&SortColumn=dd%5Fdesc. 2019. E fumaneha ho tsoa: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfPMN/pmn.cfm?start_search=1&Center=&Panel=&ProductCode=DSI&KNumber=&Applicant=PHILIPS%20MEDICAL%20SYSTEMS&TypeReview=TypeReview =&ClinicalTrials=&Decision=&DecisionDateFrom=&DecisionDateTo=07%2F24%2F2019&IVDProducts=&Redact510K=&CombinationProducts=&ZNumber=&PAGENUM=10&SortColumn=dd%5Fdesc. 2019. E hatisitsoe ka botlalo: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfPMN/pmn.cfm?start_search=1&Center=&Panel=&ProductCode=DSI&KNumber=&Applicant=PHILIPS%20MEDICAL&Type=Device=PHILIPS%20MEDICAL&Type &ThirdPartyReviewed =&ClinicalTrials=&Decision=&DecisionDateFrom=&DecisionDateTo=07%2F24%2F2019&IVDProducts=&Redact510K=&CombinationProducts=&ZNumber=&PAGENUM=10&SortColumn=dd%5F 2019. E fumaneha ho: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfPMN/pmn.cfm?start_search=1&Center=&Panel=&ProductCode=DSI&KNumber=&Applicant=PHILIPS%20MEDICAL%20SYSTEMS&TypeReview =&ClinicalTrials=&Decision=&DecisionDateFrom=&DecisionDateTo=07%2F24%2F2019&IVDProducts=&Redact510K=&CombinationProducts=&ZNumber=&PAGENUM=10&SortColumn=dd%5Fdesc. 2019. 可从:https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfPMN/pmn.cfm?start_search=1&Center=&Panel=&ProductCode=DSI&KNumber=&Applicant=PHILIPS%20MEDICAL%20SYSTEMS&TypeReview=TypeReview =&ClinicalTrials=&Decision=&DecisionDateFrom=&DecisionDateTo=07%2F24%2F2019&IVDProducts=&Redact510K=&CombinationProducts=&ZNumber=&PAGENUM=10&SortColumn=dd%5Fdesc. 2019. 可从:https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfPMN/pmn.cfm?start_search=1&Center=&Panel=&ProductCode=DSI&KNumber=&Applicant=PHILIPS%20MEDICAL%20SYSTEMS&TypeReview=TypeReview =&ClinicalTrials=&Decision=&DecisionDateFrom=&DecisionDateTo=07%2F24%2F2019&IVDProducts=&Redact510K=&CombinationProducts=&ZNumber=&PAGENUM=10&SortColumn=dd%5Fdesc. 2019. E hatisitsoe ka botlalo: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfPMN/pmn.cfm?start_search=1&Center=&Panel=&ProductCode=DSI&KNumber=&Applicant=PHILIPS%20MEDICAL&Type=Device=PHILIPS%20MEDICAL&Type &ThirdPartyReviewed =&ClinicalTrials=&Decision=&DecisionDateFrom=&DecisionDateTo=07%2F24%2F2019&IVDProducts=&Redact510K=&CombinationProducts=&ZNumber=&PAGENUM=10&SortColumn=dd%5F 2019. E fumaneha ho: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfPMN/pmn.cfm?start_search=1&Center=&Panel=&ProductCode=DSI&KNumber=&Applicant=PHILIPS%20MEDICAL%20SYSTEMS&TypeReview =&ClinicalTrials=&Decision=&DecisionDateFrom=&DecisionDateTo=07%2F24%2F2019&IVDProducts=&Redact510K=&CombinationProducts=&ZNumber=&PAGENUM=10&SortColumn=dd%5Fdesc.Ho tloha ka la 14 Phato 2019